摘要
目的:研究伴胸腺瘤的重症肌无力(MG)患者术后放射治疗的效果。方法:观察和比较60例伴胸腺瘤MG患者术后放疗与43例术后未放疗患者的远期疗效和生存率。结果:术后放疗组的50例(83.3%)患者放疗后MG症状好转。随访1~15年,MG总有效率为78.3%,其中完全缓解者12例(20.0%)、药物缓解者16例(26.7%);术后未放疗组MG总有效率为79.1%,其中完全缓解者16例(3.2%)、药物缓解者5例(11.6%),两组远期疗效差别无统计学意义(P>0.05)。术后放疗组2、5和 10年生存率分别为 93.3%、80.0%和 467%,其中 Masaoka分期 Ⅰ-Ⅱ期者分别为 97.6%、92.8%和 83.3%,Ⅲ-Ⅳ期者分别为83.3%、50.0%和0%;术后未放疗组2年、5年和10年生存率分别为86.0%、74.4%和48.8%,其中Ⅰ-Ⅱ期者分别为94.7%、86.8%和71.l%,Ⅲ-Ⅳ期者分别为40.0%、0%和0%。两组Ⅲ-Ⅳ期患者生存率比较具有统计学意义(P<0.01)。结论:放射治疗可以提高伴浸润性胸腺瘤的MG患者远期生存率和缓解MG症状。
Objective: To evaluate the long-term outcome of radiotherapy in treatment of myasthenia gravis(MG) withthymoma. Methods: Sixty cases of MG with surgically proven thymoma were treated with radiotherapy and compared with 43cases without radiotherapy. The long-term outcome of MG and the survival rates were evaluated. Results: In 50 patients(83.3% ) symptoms of myasthenia gravis improved after radiotherapy. Follow-up data showed that overall effective rate ofmyasthenia gravis was 78.3 %, 12 patients had complete remission (20.0% ) and 16 had pharmacologic remission (26.7% ).In the non-radiotherapy group, overall effective rate was 79. 1 %, 16 patients had complete remission (37. 2% ) and 5 hadpharmacological remission (11.6 % ). There was on difference between these 2 groups (P>0. 05). The survival rates in theradiotherapy group were 93.3%, 80.0% and 46.7%, at 2, 5 and 10 years, respectively. The survival rates of Masaoka'sstage Ⅰ-Ⅱwere 97.6%, 92.8% and 83.3% respectively at 2, 5 and 10 years, and those of stage Ⅲ-Ⅳ were 83.3%, 50.0%and 0%. In the nonairadiotherapy group, the surviva1 rates were 86. 0%, 74. 4 % and 48. 8%, at 2, 5 and 10 years, respec-tively. The survival rates of Masaoka's stage Ⅰ- Ⅱwere 94. 7%, 86. 8% and 71. 1 % respectively at 2, 5 and 10 years, andthose of stage Ⅲ-Ⅳ were 40. 0%, 0% and 0%. Among patients stage Ⅲ-Ⅳ, survival was significantly higher for patientswith radiotherapy than for patients without radiotherapy (P<0. 0l). Conclusion: The administration of radiotherapy aftersurgery enhanced the long-term curative effects in the patients of MG with invasive thymoma.
出处
《第二军医大学学报》
CAS
CSCD
北大核心
2002年第4期430-432,共3页
Academic Journal of Second Military Medical University